The Rise and Fall of Neonatal Circumcision

The Irrational Abuse Of Helpless Children

By George Hill

November 4, 2002

The practice of circumcising male infants was once regarded as a sacred cow - immune from criticism - in the United States. Other nations, however, look on the practice as barbaric and irrational abuse of helpless children. Circumcision now is being questioned as never before. This article will review many of the reasons circumcision is coming under such new scrutiny.

The practice of male circumcision as a medical procedure started in the late 19th century. Previously, the practice of circumcision was exclusively a religious practice without any claim of medical benefit.

The first reported medical circumcision in America was performed in New York in 1870 to cure paralysis of a boy’s legs.

Circumcision was advocated to prevent masturbation in boys. In the Victorian era, medical science, if it could be called science, had little or no real understanding of the causes of mental illness. Many doctors believed that thinking immoral thoughts could somehow injure the brain, cause malfunction, feeblemindedness, and mental illness. If masturbation could be stopped by circumcision, then mental health could be promoted!

Circumcision, however, did not stop masturbation; it only caused a change in technique. Doctors then found other reasons to do circumcisions - such as epilepsy, paralysis of the bladder, and club feet. Remondino, a San Diego physician, claimed that circumcision prevented hip joint disease, hemorrhoids, bladder irritation, asthma, Bright’s disease, nocturnal pollutions, and many other harmful conditions.

Abraham Wolbarst, a New York physician, published an influential article in the Journal of the American Medical Association in 1914. The article, entitled "Universal Circumcision as a Sanitary Measure," was short on scientific evidence, but long on unsupported opinion by various doctors that circumcision was essential for good health.

Venereal disease (VD), now known as sexually transmitted disease (STD), was a major fear in those days, so circumcision was promoted to prevent contracting VD. The prevention of VD amongst the troops was a major concern, so many men were circumcised by the military forces during World Wars I and II in the mistaken assumption that circumcision would prevent contraction of VD. Today, however, medical evidence does not support the practice of male circumcision to prevent VD.

Women started to give birth in hospitals assisted by an obstetrician. Obstetricians took the opportunity to provide an additional service (for a fee of course). That service was the circumcision of baby boys before they left the hospital. These neonatal circumcisions frequently were performed without the consent of the parents.

Circumcision in the United States became almost universal. By the late 1960s, more than 90 percent of boys were circumcised soon after birth.

The year, 1970, marked the beginning of the end of this era. Important articles appeared in medical journals in Australia and the United States that refuted the benefits claimed, and in 1971 the American Academy of Pediatrics stated, "There are no valid medical indications for circumcision in the neonatal period."

An important court decision in 1972 instituted far reaching changes in American medical practice. Now, consent must be obtained only after fully informing the patient of the benefits. Infants cannot consent so the medical profession assumed that the parents could consent to the circumcision. Not all parents were willing to consent to a procedure with no medical indication, so the decline of circumcision started.

Economic and psychological forces tend to preserve the practice of infant circumcision. Doctors like the extra revenue. Also, most male doctors who practice medicine today were circumcised as infants. Males do not like to admit that the injury to their phallus was unjustified, so circumcised doctors and fathers tend to look for reasons to do a circumcision on an infant.

New evidence of risks, complications, psychological, and sexual injury are acting to oppose the forces seeking to preserve the practice of circumcision.

Complications include bleeding, infection, surgical mishaps, including urethral fistula, amputation of the head, removal of excess skin, and total loss of the penis. Death may occur from the complications of bleeding or infection.

Circumcision removes more than 50 percent of the skin and specialized mucosa from the penis. The specialized mucosa contains most of the nerve endings in the penis. Later disadvantages include painful erections due to loss of the skin necessary to accommodate penile expansion. The loss of nerves interferes with the normal operation of the autonomic nervous system resulting in premature ejaculation, inability to orgasm, and changes in sexual behavior. A survey of women found that women are four times more likely to orgasm if their male partner has an intact foreskin.

The foreskin is part of nature’s defenses against infection and disease. The moisture in the preputial sack contains lysozyme that destroys pathogens including the human immunodeficiency virus (HIV). In the infant male, the long narrow foreskin has muscle fibers arranged in a whorl at the tip to form a sphincter to keep the tip closed and fecal matter out and away from the urethra, helping to prevent urinary tract infection in infants. Circumcision destroys these natural defenses. Circumcised men have more of certain types of STD.

Circumcision trauma interferes with parent-infant bonding and the initiation of breastfeeding.

A consensus is emerging that male neonatal circumcision is not in the best interest of the child. Studies show that intact boys enjoy better penile health than circumcised boys. A British court heard evidence, determined that circumcision was not in the child’s best interests, and issued protective orders to prevent a circumcised father from having his son circumcised.

There are new ethical questions regarding the propriety of doctors excising healthy functional tissue from the penis of baby boys who cannot consent to the loss of form and function.

Parents are not getting accurate information from most doctors. Parents should see red flags when a doctor mentions circumcision to them. The medical evidence indicates that intact males enjoy better penile, physical, sexual, and emotional health, with a better sense of well being, throughout life.

Doctors Opposing Circumcision has addressed this matter in a letter to the American Academy of Pediatrics that cites numerous compromises of good medical practice, bioethics, and medical law in the AAP Circumcision Policy Statement. Furthermore, legal commentators now think that parents have no power to consent to the non-therapeutic excision of healthy functional tissue from a child’s genital organs to alter their form and function. If correct, this would mean that every non-therapeutic circumcision is a battery.

An adult male in Australia sued the doctor who circumcised him and received a substantial cash settlement for his injury. An adult male in New York recently sued the doctor and hospital alleging injuries from his neonatal circumcision. Such cases could persuade medical doctors that the continued practice of male circumcision is not in their best interest. The College of Physicians and Surgeons of Saskatchewan recently issued a warning memorandum to its doctors.

The practice of circumcision is collapsing in Australia and Canada. Six medical societies in Australia recently issued a statement condemning the practice of neonatal circumcision. The death of healthy baby boy in British Columbia two days after his circumcision has lead to harsh new criticism of the practice. The practice, already unpopular in Canada, may soon end completely there.

These medical, ethical, and legal concerns appear to be bringing the unhappy era of male circumcision to a close. Forty-two percent of American baby boys now leave the hospital intact (up from eight percent in 1970), a 525% increase, and the increase in numbers of intact boys is likely to continue. Circumcision is no longer routine and no longer sacred in America.

George Hill is a retired airline jet captain, father of an intact son, and advocate for genital integrity. He is the Executive Secretary of Doctors Opposing Circumcision http://www.doctorsopposingcircumcision.org